NR 585 Week 3 Research Article Appraisal

Student Name

Chamberlain University

NR-585: Research Methods and Evidence-Based Practice for Advanced Nursing Practice

Prof. Name:

Date

Complete APA Reference

Frontera, J. A., Wang, E., Phillips, M., Radford, M., Sterling, S., Delorenzo, K., Saxena, A., Yaghi, S., Zhou, T., Kahn, D. E., Lord, A. S., & Weisstuch, J. (2021). Protocolized urine sampling is associated with reduced catheter-associated urinary tract infections: A pre-and postintervention study. Clinical Infectious Diseases, 73(9), e2690-e2696. https://doi.org/10.1093/cid/ciaa1152

Overview of the Study

The purpose of this study was to examine whether the timing of urine sample collection affects the rate of false-positive urinalysis (UA) results in patients with indwelling catheters. The researchers aimed to determine whether a protocolized approach to urine sampling would help reduce misdiagnosed catheter-associated urinary tract infections (CAUTI). The study was conducted using a preintervention and postintervention comparison design over 18 months across two hospitals. It was structured into two nine-month periods, allowing researchers to compare data before and after implementing the protocol.

Description of the Study

The study’s research question focused on evaluating whether a standardized urine collection protocol could reduce the incidence of CAUTI. The hypothesis was that conventional urine sampling methods fail to differentiate between colonization and true infection, leading to unnecessary CAUTI diagnoses. The study aimed to assess whether an updated urine collection protocol could lower the rates of CAUTI and reduce the number of days patients required urinary catheters. Additionally, the study compared the percentage reduction in CAUTI rates at the test campus with a similar population at the control campus.

The sampling technique adhered to CDC guidelines for CAUTI prevention, which included limiting urinary catheter use, ensuring sterile catheter insertion, and maintaining appropriate catheter care. Urine specimens were collected using a sterile syringe from a disinfected needleless port. The study involved two hospital campuses—one test campus and one control campus—with a combined total of 1,100 beds. Both hospitals used the Epic electronic medical record system, had integrated quality database systems, and followed identical clinical management protocols. The research focused on patients over 18 years old who were admitted to high-risk units such as intensive care units (ICUs), medical, surgical, and neurological step-down units, or neurology floors. Pediatric patients and individuals admitted to specialty service floors were excluded.

The study identified the independent variable as the hospital campus (test versus control) where the urine collection protocol was implemented. Both campuses maintained similar infection control measures and patient care standards. However, no specific dependent variable was defined in this study.

Application to Practice

The findings from this study can be directly applied to clinical practice by improving urine sample collection protocols for patients with indwelling catheters. Implementing standardized urine collection procedures can help reduce contamination and minimize false-positive CAUTI diagnoses. This, in turn, can lead to fewer unnecessary antibiotic treatments, lower infection rates, and shorter catheter usage durations. By integrating these evidence-based practices, healthcare providers can enhance patient safety, improve clinical outcomes, and reduce hospital-acquired infections. If these results are not utilized, there is a continued risk of misdiagnosing CAUTI, leading to inappropriate treatments and prolonged patient hospitalization.